The fee guidance for medical assessments and reports required to support a veteran’s compensation claim has been updated from 9 February 2026.
The Department of Veterans’ Affairs (DVA) often pays for medical assessments and reports that have been requested to support the investigation of a veterans’ eligibility for benefits (claim assessment). The fees for these reports have been updated so that rates are more consistent with comparable fees in other jurisdictions. This is substantial increase in the fees payable for these reports since the last official update. The fees will also be indexed on 1 July each year.
DVA has written to practitioners asking them to familiarise themselves and comply with the new fee guidance. In particular, practitioners have been asked to note that:
- Payments for investigations, reports or extraneous information that have not been requested by the Department are not guaranteed.
- Rates are payable per request, not individually by condition.
- Above-rate fees will not be payable without prior written agreement from DVA.
Requests for above-rate fees will be granted in exceptional circumstances, primarily for practitioners with unusual levels of advanced training and expertise, or where circumstances may otherwise justify such as very complex and rare conditions requiring extensive investigation. DVA is consulting with the Australian Medical Association about when above rates fees may be appropriate. Requests for above-rate fees should be made to compensation.trn.prior.approval@dva.gov.au or by completing form D9551, prior to providing the services.
Alongside the release of the new fee guidance, active monitoring of invoices has also increased and failure to comply with provider responsibilities and obligations may result in one or more of the following additional measures:
- Payment delays, while invoices are reviewed.
- Providers may be placed on hold – meaning invoices from the practitioner will not be processed while an investigation into billing practices is ongoing.
- Where repeated inappropriate billing practices are identified, DVA may refuse to issue Transaction Reference Numbers (TRNs) to, or accept and pay for any reports, from the relevant practitioner or practice.
Medical providers receiving financial benefits from non-disclosed links to corporate structures will be referred to the Australian Health Practitioner Regulation Agency (Ahpra). Modification of any medical forms and reports may also be treated as fraud and referred to Ahpra and law enforcement agencies as relevant. This includes where a practitioner has provided a report that is essentially drafted or completed by an advocate or advocacy group, or where a practitioner has provided a report that is then modified or adjusted by an advocacy group prior to receipt by DVA.
These updates are part of DVA’s work to safeguard the integrity of the veteran support system to make it easier for veterans and families to access fair, transparent, and accountable care and compensation that supports their wellbeing.
DVA acknowledges and appreciates the important role played by medical practitioners in the assessment of claims from veterans. These new compliance measures are not expected to affect most practitioners who bill appropriately.
The updated fee guidance is available on the DVA website at: www.dva.gov.au/providers/fees-claims/fee-notes-gps-and-specialists.